初发单眼眼前黑影飘动患者的光相干断层扫描特征  

Spectral domain optical coherence tomography imaging characteristics in patients with initial onset floaters

作　　者：张露 王永晶 贾君 赵健楠 赵芳 ZHANG Lu;WANG Yongjing;JIA Jun;ZHAO Jiannan;ZHAO Fang(Department of Ophthalmology,the Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属武汉市中心医院眼科,湖北武汉430014

出　　处：《山东大学耳鼻喉眼学报》2025年第1期85-88,116,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：武汉市中心医院学科基金(2021XK017)。

摘　　要：目的探讨初发单眼黑影飘动患者光相干断层扫描(optical coherence tomography,OCT)的影像特征。方法本研究为前瞻性病例系列研究。将主诉为1周内单眼黑影飘动113例(113眼)纳入本研究。所有患眼在基线和6周后行视力、眼压、裂隙灯显微镜、散瞳间接眼底镜、超广角扫描激光眼底成像(scanning laser fundoscopy,SLO)、OCT检查。SLO和OCT的图像采集在散瞳前进行。结果视网膜裂孔在玻璃体腔点状高反射阳性组和阴性组占比分别为29.2%和2.2%(χ^(2)=21.856,P<0.001)。周边部视网膜前条带状出血在玻璃体腔点状高反射阳性组和阴性组占比分别为29.2%和1.1%(χ^(2)=26.139,P<0.001)。OCT的红外谱图(infrared spectroscopy,IR)中,视网膜裂孔在多个视网膜前遮挡影阳性组和阴性组占比为38.5%和4%(χ^(2)=18.639,P<0.001)。周边部视网膜前条带状出血在多个视网膜前遮挡影阳性组占比高于阴性组,差异均有统计学意义(χ^(2)=48.839,P<0.001)。结论初发单眼黑影飘动患者的OCT上观察到玻璃体腔点状高反射,IR图中出现多个视网膜前遮挡影,需考虑视网膜裂孔或视网膜前出血。Objective To observe the imaging features of optical coherence tomography(OCT)in patients with incipient monocular black shadow flutter.Methods This study was a prospective case series.113 cases(113 eyes)with complaints of monocular dark shadow flutter within 1 week were included in this study.All affected eyes underwent visual acuity,intraocular pressure,slit lamp microscopy,indirect fundoscopy with dilated pupil,super wide angle scanning laser fundoscopy(SLO),and OCT at baseline and 6 weeks later.image acquisition for SLO and OCT was performed before dilating the pupil.Results The proportion of retinal tears in the vitreous cavity with punctate hyperreflectivity was 29.2%and 2.2%in the positive and negative groups,respectively(χ^(2)=21.856,P<0.001).The preretinalstriated hemorrhages of the peripheral cavity were 29.2%and 1.1%(χ^(2)=26.139,P<0.001)in the vitreous cavity punctate hyperreflective positive and negative groups,respectively.In infrared spectroscopy(IR)of OCT,retinal fissures were 38.5%and 4%(χ^(2)=18.856,P<0.001)in the positive and negative groups of multiple pre-retinal occluding shadows.4%(χ^(2)=18.639,P<0.001).Peripheral pre-retinal strip hemorrhages were more prevalent in the multiple pre-retinal masking shadow positive group than in the negative group,and the difference was statistically significant in all cases(χ^(2)=48.839,P<0.001).Conclusion The observation of punctate hyperreflectivity of the vitreous cavity in OCT and the presence of multiple pre-retinal masking shadows on IR maps in patients with initial monocular black shadow flutter need to be considered for retinal tears or pre-retinal hemorrhages.

关 键 词：玻璃体腔点状高反射 光相干断层扫描 视网膜裂孔 黑影飘动 视网膜脱离 

分 类 号：R776.4[医药卫生—眼科]